Objective: To investigate systematically the effects of sensorineural hearing loss on cortical event-related potentials (ERPs) N1, MMN, N2 and P3 and their associated behavioral measures (d' sensitivity and reaction time) to the speech sounds /ba/ and /da/ presented at 65 and 80 dB ppe SPL.
Design: Cortical ERPs were recorded to /ba/ and /da/ speech stimuli presented at 65 and 80 dB ppe SPL from 20 normal-hearing adults and 20 adults who are hearing impaired. The degree of sensorineural impairments at 1000 to 2000 Hz ranged from mild losses (defined as 25 to 49 dB HL) to severe/profound losses (75 to 120 dB HL). The speech stimuli were presented in an oddball paradigm and the cortical ERPs were recorded in both active and passive listening conditions for each stimulus intensity.
Results: Both ERP amplitudes and behavioral discrimination (d') scores were lower for listeners with sensorineural hearing loss than for those with normal hearing. However, these differences in response strength were evident only for those listeners whose average hearing loss at 1000 to 2000 Hz exceeded 60 dB HL for the lower intensity stimuli and exceeded 75 dB HL for the higher intensity stimuli. In contrast, prolongations in the ERP and behavioral latencies, relative to responses from normal-hearing subjects, began with even mild (25 to 49 dB HL) threshold elevations. The amplitude and latency response changes that occurred with sensorineural hearing loss were significantly greater for the later ERP peaks (N2/P3) and behavioral discrimination measures (d' and RT) in comparison with earlier (N1, MMN) responses.
Conclusions: The results indicate that latency measures are more sensitive indicators of the early effects of decreased audibility than are response strength (amplitude, d' or percent correct) measures. Sensorineural hearing loss has a greater impact on higher level or "nonsensory" cortical processing in comparison with lower level or "sensory" cortical processing. Possible physiologic mechanisms within the cortex that may be responsible for these response changes are presented. Lastly, the possible clinical significance of these ERP and behavioral findings is discussed.